As noted in a recent report by the National Academies of Sciences, Engineering<br />and Medicine, Americans are more likely than those in other high-income countries “to find their health care inaccessible or unaffordable and to report lapses in the quality and safety of care outside of hospitals.”<br />If American history provides any sort of guidance, it is that continuing to shred the social safety net will definitely make things worse.<br />Public social spending writ large — including health care, pensions, unemployment<br />insurance, poverty alleviation and the like — reached 19.3 percent of G.<br />David M. Cutler, an expert on the economics of health care at Harvard University, put it like this: “No other<br />Congress or administration has ever put forward a plan with the intention of having fewer people covered.”<br />Under the House Republican plan, 24 million more Americans will lack health insurance<br />by 2026, according to the nonpartisan Congressional Budget Office.